Obstetric fistula is an injury to the birth canal, resulting from prolonged labour, that has devastating physical and psychological effects on women’s lives.Its persistence reveals vast inequities in access to and quality of reproductive health care.

Living Testimony: Obstetric Fistula and Inequities in Maternal Health brings together the voices of women from 29 countries in Africa, the Arab States, and Asia, who speak out about life with obstetric fistula. Their families, community members, and health care providers share knowledge, attitudes, and perspectives on pregnancy, delivery, and fistula. This advocacy publication presents promising practices and strategic recommendations for policy makers, programmers, and researchers seeking to improve access to vital maternal health services and strengthen fistula prevention and treatment programmes in affected countries. Living Testimony was produced by Family Care International and UNFPA in 2007, and is available in English and French.

A toolkit with additional advocacy tools was published in CD-ROM format in 2010. It aims to provide guidance and tools to conduct advocacy for improving maternal health, and highlights how perceptions, knowledge, and attitudes related to pregnancy and delivery affect maternal mortality and morbidity, including obstetric fistula. The following tools are also available for download here:

Other resources, including useful websites focused on maternal health and obstetric fistula, regional and national statistics on maternal health, related publications, and multimedia resources, are available on the CD-ROM version of the toolkit, which can be ordered by contacting pubs (@) familycareintl (dot) org.